The doctor will take a history in order to gather information on the events of the exposure and the medical condition prior to the cold injury.
- The doctor will take note of the vital signs, including temperature, pulse, blood pressure, and respiratory rate in order to exclude or treat any immediate life threats such as hypothermia or severe infection.
- X-rays or other imaging studies may be performed, but they probably will be deferred until weeks later when they are more useful to the treatment team.
- The doctor will collect data in order to classify the injury as superficial or deep and the prognosis as favorable or poor.
A good prognosis is heralded by intact sensation, normal skin color, blisters with clear fluid, the ability to deform the skin with pressure, and the skin becoming pink when thawed.
Blisters with dark fluid, skin turning dark blue when thawed, and an inability to indent the skin with pressure indicate a poor prognosis.
The first step for a person who may have frostbite is to call for medical help. If you are in an area that has an emergency medical alert system such as 911, while attending to the injured person, have someone call 911 and best explain the condition of the patient. Remove all wet clothing from the affected area, and elevate the area higher than the heart if possible to avoid swelling. Keep the person dry and warm. If they are immobile, and unable to walk try to keep the person busy with conversation. Keep the body warm and dry if possible.
Frostbite Self-Care at Home
First, call for help.
Keep the affected body part elevated in order to reduce swelling
Move to a warm area to prevent further heat loss.
Note that many people with frostbite may be experiencing hypothermia. Saving their lives is more important than preserving a finger or foot.
Do not walk on frostbitten toes or feet if at all possible.
Remove all wet clothing and constrictive jewelry because they may further block blood flow.
Give the person warm, nonalcoholic, noncaffeinated fluids to drink.
Apply a dry, sterile bandage, place cotton between any involved fingers or toes (to prevent rubbing), and take the person to a medical facility as soon as possible.
Never rewarm an affected area if there is any chance it may freeze again. This thaw-refreeze cycle is very harmful and leads to disastrous results. If medical care is not immediately available and there is no chance of refreezing, you can use body heat to warm an injured body part (for example placing frostbitten fingers beneath the armpit). Another option if medical care is not readily available, and there is no chance of refreezing, is to immerse the affected areas in warm (not hot) water.
Do not rub the frozen area with snow (or anything else). The friction created by this technique will only cause further tissue damage.
Above all, keep in mind that the final amount of tissue destruction is proportional to the time it remains frozen, not to the absolute temperature to which it was exposed. Therefore, rapid transport to a hospital is very important.
Medically Reviewed by a Doctor on 3/2/2016
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